Get your Health question answered in 3 easy steps

127 Doctors Online
Doctor Image
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

I will be looking into your question and guiding you through the process. Please write your question below.

Bloating, diarrhea, constipation. EGD shows gastritis. CT scan shows splenule. Stool sample shows fat positive. Problem?

Answered by
Dr.
Dr. Charles S Narasi

Gastroenterologist

Practicing since :1962

Answered : 693 Questions

default
Posted on Fri, 12 Apr 2013 in Digestion and Bowels
Question: Hi- my name is XXXXXXX and I have had bloating/ episodes going back and forth from diarrhea and constipation. I get really bloated at times, and feel like CRAP. The doctor did a few tests on me and this is what it included
Colonoscopy- it came back normal with XXXXXXX hemmroids found only- biopsies done- normal no findings
EGD- -Found gastritis - otherwise normal also did biopsies
HIDA Scan- Normal it states "Normal Hepatobiliary scan with normal gallbladder ejection fraction of 47%
Abdominal Cat Scan with constrast- Normal it stated "The lung bases are clear. The Liver,spleen,
gallbladder,pancreas,kidneys, and adrenal glands are within Normal limits. A small splenule is noted anterior to the spleen. No mass or adenopathy is seen. No bowel wall thickening, edema, pneumoperitoneum or ascites is evident. The uterus and adnexa are unremarkable. No osseous is seen
Lipase- Normal range
Amylace- Normal range
Ultrasound of the right upper quandrant said "Liver is unremarkable in contour, shape and parenchmal echogenicity. There is no evidence of intra or extrahepatic bililary dilation with the CBD measuring 2mm. Gall bladder is unremarkable with no evidence of Cholelithiasis. The Visualized portion of the pancreas is unremarkable with the body and tail not well visualized due to overlying bowel gas. Screening images of the right kidney demonstrate no XXXXXXX hydronephrosis and unremarkable cortical echogenicity. The right Kidney measures 10.8cm in length Impression : Unremarkable rruq ultrasound
He did some kind of autoantibody for autoimmune pancreatitus- came back negetive
then he did stool samples for OvaParasites- negetive
stool sample blood- negetive
The only positive was stool sample for fat -Positive
Celiec disease- serum and biopsy -negetive
Hpylori Biopsy-negetive
Hemaglobin A1c -normal 5.6
CBC- Normal except very mild anemia Hemaglobin was 11.8 Hematocrit 36.2, wbc-5.9
BMP-normal last one bilirubin was 0.4, albumin 4.1 Sodium 143 Potassium 4.2 Calcium 9.6 Chloride 106 BUN 10 Creatinine 0.8 ,glucose 78, total protien 8.1 Alkaline Phos 50
Albumin that was in the BMP or CBC (forget which one thats in) was normal range
Carcinoid- was ruled out by a weird blood test.
All my thyroid levels were chcecked including TSH T4 T3 T7 and thyroid antibodies all normal.... (this was checked in depth due a nodule- which was benign)
I have had many chest Xrays- all negetive

All he did was leave me a message telling me theres fat in my stool and we will talk on monday- but when I look it up it could mean pancreatic cancer, bililary tract cancer, Whipples disease, all of these fatal things, all sorts of cancers and odd disorders :( which makes me nervous

My history prior to this was I had a premature birth of a baby in october , while in the hospital they gave me vancomycin,zyvox and I think zosyn for the fear of a uterine infection (which I did not have) for 3 days i had a temp of 99.5 and that was dude to a sinus infection but htey wouldnt believe me. could that have wiped out my enzymes? could I have Small bowel overgroweth?. Otherwise I have been a very healthy person my whole life. I do not have any jaundice seen in my skin or eyes. ive lost a total of 14lbs since december im 5'3
doctor
Answered by Dr. Charles S Narasi 1 hour later
Hello, XXXXXXX,
I am glad to see that you have provided very extensive
reports of what has been done so far. I am a little concerned
about your weight loss and mild anemia. All your other blood work
looks fine. They did find fat in your stool. What you need is 72 hour
quantitative stool for fat which would indicate if you have fat
malabsorption and pancreas problem. Eventhough you have had
a normal appearing pancreas on the sonogram, you need a little
more sophisticated study to look at pancreas. This might include
CT-Scan of the pancreas and or MRCP to be followed by ERCP
(Endoscopic retrograde cholangio pancreatography) where they
can get into the duct of the pancreas , collect fluid and also do
a biopsy to determine if you have pancreas problems including
pancreatic cancer.
From what I see, you have had a very good work up so far.
But you need to have these additional studies to narrow down
what is causing your symptoms. You asked about bacterial
overgrowth syndrome. You can have bloating, gas, diarrhea etc
with this , but antibiotics usually control the symptoms.
When you were on the Vancomycin and Zosyn, if you felt better
that might indicate or support that.I also suggest that you get some cancer
markers such as CEA and CA-129 etc.
I hope you can discuss these with your doctor and take proper
action.
I wish you the very best.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
default
Follow up: Dr. Charles S Narasi 6 minutes later
Being 26 years old would that have a good indication of pancreatic cancer ? Most of my problems started after the premature birth of my baby; 2 weeks after her birth this started. are there other reasons for fat malabsorbtion other than Pancreatic Cancer? I am very nervious about that fact & wish it wasn't a possibility.
doctor
Answered by Dr. Charles S Narasi 7 minutes later
Hello, XXXXXXX
You are only in your twenties and the possibility
of pancreatic cancer is very low at this age group.
It is possible that you may have have what is called
"Pancreatic insufficiency " probably from recurrent
inflammation. If you have not had a small bowel
x-ray series, I would suggest you get that to find
out if you have any signs of early Crohn's disease
that might account for malabsorption.
I wish you well.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
default
Follow up: Dr. Charles S Narasi 3 minutes later
THank you- I think the doctor told me the next step was going to be a barium swallow test with a camera to look at the area of my bowels that the colonoscopy and EGD cannot see? Maybe thats the same test your talking about- the doctor just stated ont he phone he wanted to start me on a medication for pancreatic enzymes, I was wondering if I could of Depleted those enzymes by recieving very potent antibiotics when I didn't have an actual infection, but maybe not.
doctor
Answered by Dr. Charles S Narasi 10 hours later
Hello, XXXXXXX
I think what your doctor is talking about is called
"Capsule Endoscopy" where a small capsule with
electronic devices is swallowed and after the capsule
travels the entire intestinal tract , it comes out in the
stool.
During this process the camera can take hundreds of
pictures of all of 22 feet of small intestine and the large
bowel. After the passage of the capsule , the transmitting
device is attached to the computer which can analyze all
the pictures and show any hidden abnormalities such as
Croh'n disease etc.
I do not believe the antibiotics can affect the enzymes.
Antibiotics can cause a type of colitis called "C.Difficile Colitis"
and one of the treatments is Vancomycin drug.
I wish you the very best.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
premium_optimized

The User accepted the expert's answer

Share on
Question is related to
Diseases and Conditions ,   ,   ,   ,   ,   ,   ,   ,   ,   ,   ,   ,   ,   ,   ,   ,  
Drug/Medication
Medical Procedures
Lab Tests
Medical Topics ,  

Recent questions on  X ray

doctor1 MD

Hello,My Name is Miguel, Im 18 years old and i am from Portugal.This monday I had an Math exam, I was a little nervous and i started cutting my nails with my mouth from the hand and accidently a nail got stuck in my throat. I went to the hospital next day and the doctor examined me and while he was examining he said that he touched the nail but when he does this its when i imideatly cough. He said that the nail was gone but i kept feeling the sensation that I still had something in my throat. Next day i went to the hospital again and the doctor made me a colonoscopy and he said he didnt detected nothing. I asked them for x-ray and once more they didnt saw nothing. But the question is that after 5 days i kept feeling the same sensation that i have something in my throat and im getting really really frustated and worried with this! Is there something that could make me better? :(Please, help me!

doctor1 MD

hi i about a month ago tool a detox tablet. i ordered it online and immediatly went to the hospital with heart rcing and high blood pressure. docs told me it was an over dose. now theyve put me on this 40mg heart blocker tablet which made me feel like i couldnt breath. now i have to halve the tablet. i keep getting random heart rate attcks with this weird sensation in my chest and head. im starting to get lots of pain in my chest. all bloods nowmal. x-ray normal. ultrasound normal. (fcheckd for gall stones and my appendix what could still be triggering this? when i was little i was born with a murmur and hole in my heart but docs said back then it was fine no re tetsts.

doctor1 MD

Hi I have a question about my Father he is 83 a couple of monthe s ago he fell and broke his neck ,he was at home with no treatment for a week and his GP just gave him painkillers for the awful pain,however as he did not improve he was fianally admitted to hospital x-rayed and diagnosed with a broken neck, and now has a collar to keep his neck stable.This has been on now for 6 weeks,he was x -rayed last week and they said it wasnt healing and he would need a CT the results of the CT were good and they now say he can have the neck brace off in 2 weeks . He was very pleased but ,is very distressed as he has suddenly become very deaf and has what he thinks are chilblains on his ear,also hes become extemely forgetful since all this happened, and has bad headaches and feels very unwell.He is seeing his GP again this week ,I wondered if you have any idea if his symptoms are connected with his broken neck ,and also can mistakes be made by a doctor when reading a ct scan ? Its very difficult for me as I live in Japan and my father in the UK, Thank you for any advice you can give me,from Shirley My father is 83 about 11stone has oestioporosis,and a history of broken bones.

doctor1 MD

Am querying current line of thinking by several consultants. Admitted to hospital May 2011; lumbar puncture showed elevated CSF protein of 1088 mg/L with 228 white cells, 95% lymphocytes. The working diagnosis was viral meningitis, and I was discharged after 2 days aciclovir. Negative for herpes simplex virus 1 and 2. Developed infection in leg early October 2011, followed by painful groin, then ulcers either side of scrotum - non painful, and diagnosed as shingles. Mid October 2011, following tinitus, buzzing , hearing different frequencies, then vertigo, admitted for 2 weeks in ID ward...CSF showed 614 white cells with 90% lymphocytosis. CSF protein raised at 1335 mg/L. Tested for everything under the sun, incl. HIV, syphillis, Lyme disease, Cat scratch fever (leg infection thought to have been through an insect bite). All negative, incl. ANA. Chest x-ray, MRI scan of brain and whole spine also negative. Admitted again 26th December 2011, aciclovir for seven days, now back home feeling well, if a little tired. Current thought is Mollarets meningitis, but more recently, rheumatology dept. thinking Behcets syndrome, as I suffer from mouth ulcers. My contention is this; I have sufferd from mouth ulcers since a teenager taking exams at school. If I have a job interview, I will get mouth ulcers after @ 48 hours. Dentist thinks stress induced, as do I. I have no aching joints and no eye irritation, also, just found out that HLAB51 negative. I am a 42 year old British male and caucasian. I can t help feeling there s a square peg being pushed into a round hole here. What about migraine; the tinitus, buzzing and vertigo? Also, I took a non-steroidal (Ibuprofen) prior to the first two episodes. Bickerstaff s encephalitis sounds just as plausible as Behcets...or am I in denial? I would appreciate any advice, even if it s to simply face the music . Thank you for your time.

doctor1 MD

I am having a frozen left shoulder kind of symptoms for last couple of months. My left shoulder doesnt rotate as smoothly as the right one. My second problem is I have constipation atleast few days a month and suffer from piles as a consequence

doctor1 MD

I have very shortness of breath will divan help this ?

doctor1 MD

I have to urinate often ..... if I stand up from sitting position or sleep position. And I empty out every time. My family Dr. thinks my bladder has fallen and there by impairing the normal muscle function that holds the urine until some normal...